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79 Cards in this Set
- Front
- Back
247. Genital chancre begins as a papule, ulcerates to form a single, painless, clean-based ulcer. TOW?
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1o syphilis
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248. Cause of genital chancre, begining as a papule, ulcerating to form a single, painless, clean-based ulcer.
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Treponema pallidum
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249. A pen-allergy, non-pregnant, female pt w/ fever, "copper penny" macular lesions on the palms or soles; RPR(+) should be treated with
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Doxycycline
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250. Management choice of tabes dorsalis (10-20yrs), iritis, uveitis, or Argyll-Robertson pupils of pen-allergy in a pregnant woman w/ pen allergy; RPR(+) is
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Desensitization
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251. Hx of painful clustered vesicles with an erythematous base; urinary retention in a promiscuous woman. TOW?
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HSV-2 >> 1
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252. Giemsa stain of fluid from a herpetic lesion should reveal
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Multinucleated giant cells
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253. Patient with genital herpes does not respond to acyclovir because pt is infected with
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thymidine kinase deficient HSV
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254. A pregnant woman with 1o symptomatic HSV-2 infection is at risk of her baby developing
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neonatal (congenital) herpes
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255. Cause of painful genital ulcers; purulent, grey base; painful inguinal adenitis, in a man with multiple sexual partners is
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Haemophilus ducreyi
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256. Fastidious organism in the infiltrate of the penile ulcer, co-localized with neutrophils and fibrin, in a pt w/ chancroid is
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Haemophilus ducreyi
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257. All sex partners of pt with chancroid, regardless of symptoms, should be examined and treated with
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Azythromycin > ceftriaxone
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258. Most common cause of mucopurulent endocervical exudate (Gram stain non revealing) in a sexually promiscuous woman
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Chlamydia trachomatis D-K
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259. Dx of mucopurulent urethral discharge, dysuria, penile pruritis is based on
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NAAT of urethral specimen or urine (+)
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260. DOC of most frequent cause of nongonococcal urethritis
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Azythromycin > doxycycline
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261. Cause of rare genital ulcers, inguinal lymphadenopathy [cytology(-) for multi-nucleated giant cells; RPR (-)] in men is
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Chlamydia trachomatis L1-L3
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262. Hx of systemic Sx/Sn w/ cervical motion tenderness in a woman with turbo-ovarian abscess. TOW?
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PID
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263. Cause of mucopurulent urethritis, dysuria, penile pruritis [Smear (+):Gram-negative diplococci co-populated w/ PMNs] is
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Neisseria gonorrhoeae
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264. Deficiency in serum factors in a female pt w/ frequent gonorrhea and DGIs is
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C6-C9
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265. Immune evasion of Neisseria gonorrhoeae in frequent mucosal infection is due to
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Antigenic variation of pili.
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266. Auxotrophic strains of N. gonorrhoeae with serum (complements) resistance are likely to cause
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Septic arthritis (aka: DGI)
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267. Most frequent complication of gonococcal (GC) infection in men
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Epididymitis
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268. Cause of "bull headed clap", urethral stricture, prostatitis is
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Neisseria gonorrhoeae
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269. Urethritis is treated with ceftriaxone + azythromycin because
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Concurrent GC + Chlamydia
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270. An older woman with PID and tubo-ovarian abscess receives ceftriaxone, azythromycin, and metronidazole because
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Polymicrobic (endogenous) infection
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271. Cause of anogenital warts w/ histology (+): koilocytes is
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HPV 6 and 11
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272. Cause of atypical squamous cells of undetermined significance (ASCUS) on pap smear w/ no clinical signs of infection is
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HPV 16 and 18
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273. Cause of koilocytotic cells and possible progression to squamous cell carcinoma
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HPV 16 and 18
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274. Next step to identify viral cause of ASCUS on pap smear w/ and further management in a woman of age > 29 years is
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Colposcopy > HPV DNA in bpsy
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275. Wet prep of vaginal discharge from a pt w/ vaginal pruritis; ectocervical erythema ("strawberry cervix") should reveal
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motile tissue flagellate
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276. Gram stain of vaginal discharge w/ fishy odor from a pt w/ vaginal pruritis but no erythema and normal cervix should reveal
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SECs stippled with Gram-variable organisms.
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277. Pathology of bacterial vagisnosis is overgrowth (in vagina) of anaerobic Mobiluncus species and
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Gardnerella vaginalis
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278. DOC of bacterial vaginosis is
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metronidazole
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279. Wet prep of curdy discharge (no odor), adhering to vaginal walls, from a pregnant woman w/ recent UTI, who now has severe vaginal pruritis; vulvovaginal area - erythematous should reveal
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budding yeasts with pseudohyphae
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280. Normal commensal of skin, GI & GU tracts; endogenous overgrowth of budding yeast, capable of >10 diseases. TOW?
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Candida albicans
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281. Mechanism of action of a po DOC of vulvovaginal candidiasis is
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blocks C14α-lanosterol demethylase
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282. Hx of flu-like illness, lymphadenopathy, maculopapular rash in a bisexual man. Lab: lymphopenia and transaminase elevations; monospot/all serology (-). TOW?
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Acute retroviral syndrome
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283. Time from infection (acquisition) to acute seroconversion detected by HIV serology (ELISA/ WBlot) is
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6-12 weeks.
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284. Hx of mononucleosis-like illness and lymphadenopathy in a man who has sex man. Serology (-). What is HIV viral load?
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>10,000 copies/ml
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285. Host-cell receptor for HIV-1 infection
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CD4
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286. Homozygous for deletions in what gene renders resistance to infection and some protection against progression.
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CCR5
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287. Host cells that trap HIV and mediate the efficient transinfection of CD4+ T cells are
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Dendritic cells
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288. A man, who practices “sex with another man”, has antibodies to HIV (ELISA and WB) but asymptomatic. TOW?
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Clinical latency
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289. What happens to HIV-1 virus when acute retroviral syndrome progresses to clinical latency?
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Virus continues to replicate low level.
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is i. Candidiasis, esophageal, bronchi, trachea, or lungs
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is ii. Cervical cancer, invasive
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is iii. Coccidioidomycosis, extrapulmonary
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is iv. Cryptococcosis, extrapulmonary
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is v. Cryptosporidiosis, chronic intestinal
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is vi. Cytomegalovirus retinitis (with vision loss)
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is vii. Encephalopathy, HIV-related
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is viii. Herpes simplex - Chronic ulcers
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is ix. Histoplasmosis, disseminated or extrapulmonary
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is x. Isosporiasis, chronic intestinal (duration >1 mo)
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xi. Kaposi sarcoma
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xii. Lymphoma, Burkitt
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xiii. Lymphoma, primary, of the brain
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xiv. Mycobacterium avium complex or Mycobacterium kansasii infection, extrapulmonary
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xv. Mycobacterium tuberculosis infection, any site (pulmonary or extrapulmonary)
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xvi. Pneumocystis pneumonia
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xvii. Progressive multifocal leukoencephalopathy
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CD4+ < 200/μL
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290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xviii. Wasting syndrome due to HIV infection
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CD4+ < 200/μL
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291. A man with HIV infection has chronic diarrhea, oral thrush + toxoplasma encephalitis. Most likely CD4+ count is
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< 50 cells/μL.
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292. Most common cause of HIV- associated peripheral skin or mucosal ulcers
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HSV-1 (>> Histo > CMV > VZV > Syphilis)
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293. Most common cause of HIV- associated nodules (neoplasia)?
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HHV-8 (aka KSHV)
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294. Hx of fatigue, nausea, abdominal pain, diarrhea, fever, chills, night sweats, dry persistent cough w/ SOB and weight loss in a man with AIDS. Lab: PPD (-); blood culture (+) for AFB. TOW?
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Mycobacterium avium-intracellulare (MAI) complex (aka: MAC)
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295. Common cause of retinitis, viral pneumonitis or esophagitis in AIDS
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CMV
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296. Cases of CMV disease occur with immunosuppression level
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CD4< 50
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297. cytopathology of CMV infected tissue is characterized by large cells with
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nuclear (Cowdry owl’s eye) and cytoplasmic inclusions
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298. Hx of progressive CNS dz in a pt w/ AIDS: hemiparesis, visual, ataxia, aphasia, cranial nerves, sensory. Head MRI: ring-enhancing lesions. Toxo antibody (-). TOW?
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JC virus
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299. Definitive indication for initial HAART is CD4+ count?
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350/mm3.
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300. Objective of ARV Tx is to reduce viremia to what level of genomic RNA/mL
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< 50 copies RNA/mL.
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301. Initial regimen of anti-retroviral therapy is
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Emtricitabine + Tenofovir + Efavirenz
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302. Abacavir, emtricitabine, lamivudine, zidovudine, tenofovir belong to what class of antiretrovirals?
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NRTIs
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303. Efavirenz, nevirapine belong to what class of antiretrovirals?
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NNRTIs
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304. Atazanavir, Lopinavir, Saquinavir belong to what class of antiretrovirals?
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Protease inhibitors
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305. This drug binds to gp41 and prevents conformational change required for viral fusion and entry into cells.
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enfuvirtide
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306. This drug inhibits integrase, responsible for insertion of HIV proviral DNA into the host genome.
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raltegravir
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307. A man has AIDS and CD4 <200cells/μL or thrush. Antibacterial prophylaxis needed besides HAART is
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TMP-SMX (for PCP)
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308. A man has AIDS and CD4 <100 + pos toxo IgG. Chemoprophylaxis needed besides HAART is
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TMP-SMX (for Toxoplasma encephalitis)
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